Sylvia leaned forward with her elbows on the banister. She loved listening to him, hearing about a side of him that was otherwise hidden from her. "How's that?"

"Well, my school had this philosophy of teaching you all about every organ in the body but never letting you forget that it was part of a person. They always stressed the old cliche of the whole being greater than the sum of its parts. We were never supposed to treat John Doe's heart disease— we were always to treat John Doe who happened to have heart disease."

"Sounds like semantics."

"Yeah. I thought it was a word game, too. But there's a world of difference when you put the two approaches into practice. But getting back to pediatrics, I've come to see that I can practice better office pediatrics as a family doctor than as a pediatrician."

Sylvia laughed. She knew a few pediatricians who might take issue with that.

"I'm serious. Best example I can think of is a nine-year-old girl in a few months ago with stomach pains, weight loss, and sinking grades in school. If I were a pediatrician I'd start ordering a battery of blood tests, and when they came out negative, maybe even some barium X-ray studies. But I didn't."

"Flying by the seat of your pants again?" she said, remembering Tuesday night and Jeffy's bellyache.

"Not at all. Because over the past year I'd seen the mother three times for sprains, bruises, and contusions. Each time she'd say she had fallen, but I know what it looks like when someone gets punched in the nose. I confronted her; she admitted that her husband had been getting physically abusive over the past year; I sent them for family counseling, and when I last saw the girl her stomachaches were gone, she had regained her lost weight, and was performing back up to par in school."

"And you don't think a pediatrician could do that?"

"Of course. I'm not saying I'm a better pediatrician per se. I'm saying that because I treat whole families, I have a more direct line into what's going on in the home, which allows me a perspective no specialist has."

Sylvia saw Virginia Bulmer and Charles stroll into view below, and noted with a flash of satisfaction the relieved expressions on both their faces when they looked up and saw Alan and her standing in plain sight.

Lou Alberts, her uncle and Alan's old partner, came out to make it a threesome.

Alan apparently saw them, too.

"I guess I'd better get you back to your guests," he said.

Was that a note of reluctance in his voice?

"If you must," she said, looking him in the eyes.

Alan offered her his arm.

She sighed and allowed him to lead her down. It really was time to get back to the party—Switzer and Cunningham would be bumping into each other soon and she didn't want to miss that.

Mike Switzer came up and grabbed Alan's arm as he reached the bottom of the stairs.

"Alan!" he said, all smiles. "You did it!"

"What? Did what?" Alan said. Sylvia smiled, gave his arm a squeeze, and drifted away.

"The Guidelines bill! It's gone back to committee!"

"Is that good?"

"Hell, yes! It means it won't get tacked onto the Medicare appropriations, which puts it in limbo for a while."

Alan's rising spirits dipped. "So it's still alive."

"Yes, but it's wounded. And nowadays that's the best we can hope for." He slapped Alan on the back. "And you helped wound it, buddy!"

"The pleasure was all mine."

"Great! Just don't run against me in my district."

"Never fear," Alan said with heartfelt sincerity. "If I never see one of those committee rooms again it will be too soon."

"That's what I like to hear!" Switzer suddenly sobered. "But be alert for any of the senator's aides who may come around and say they want to 'get you on the team' where they can have 'easy access to your valuable insight.' They'll offer positions on things like study groups and the like. Ignore them."

"Why? Not that I have time for that kind of thing—but why ignore them?"

"It's an old trick," Mike said in an exaggerated conspiratorial whisper from the corner of his mouth. "You get your most articulate critics off guard by appearing open to their ideas, then you lose them in your study groups, sub-subcommittees, brain trusts, etcetera. You muffle them by burying them under tons of paper and red tape."

"Nice town you work in."

Mike shrugged. "If you know the rules, you can play the game."

"When it starts worming its way into my examining rooms," Alan said, "it's not a game anymore."

As Congressman Switzer drifted off to press flesh with other guests, Axford strolled by and stopped at Alan's side.

"So what field are you in?" Alan asked in an apparent attempt at making small talk with Axford; actually, he was curious as to what sort of man interested Sylvia.

"Research. Neurology."

"One of the schools? Pharmaceutical company?"

Axford shook his head. "Private. The McCready Foundation."

"Oh, God!"

Axford smiled. "Now don't get your knickers in a twist."

Alan couldn't help the sour look on his face. "But McCready… Christ! Wasn't it his kind that drove most of the good doctors out of England?"

Axford shrugged. "The famous 'Brain Drain'? I don't know and I don't bloody much care. National Health was already on the scene when I entered medical school. I just go where the research dollars are."

Alan felt an almost instinctive hostility rise in him. "So you come from a tradition of doctors as government employees. Must make it easy for you to work for McCready. Ever meet him?"

"Of course."

"What do you think of him?"

"His Circle of Willis is clogged with fecaliths."

Alan burst out laughing. Axford was anything but charming, but his candor was endearing. So was his wit. Alan had never heard anyone called a shithead in such an oblique manner.

"Do I detect a note of hostility toward academic medicine?" Axford said.

"No more than the average clinician."

"And I suppose you think you can get along just ducky without the research physician and the academician?"

"They have their places, but when a guy who hasn't laid a finger on a living patient since 1960 condescends to tell me how to practice clinical medicine—"

"You mean you actually touch people?" Axford said with an exaggerated grimace of distaste.

Lou Albert was passing by then and Axford caught him by the elbow.

"I say, why don't we three doctor-types stand around and talk shop, what? I understand you two were partners once upon a time. Is that so?"

Lou looked decidedly unhappy, but he stopped and nodded. He was shorter than either Alan or Axford, and at least a decade older, but he stood tall as always with his military-straight spine and gray, crew-cut hair. "You know damn well that's so. You asked me about it an hour ago."

"That's right, that's right. I did, didn't I?" Alan saw a gleam begin to glow in Axford's eyes. His smile became vulpine. "Years ago, wasn't it? And didn't you tell me that Alan here stole a lot of patients from you?"

Lou's face reddened. "I said no such thing!"

"Oh, do come along, old fellow. I asked you how many patients he stole from you and you said… ?" Axford's voice curved up at the end like the barb on a hook.

"I said 'a few,' that's all."

Alan couldn't fathom what Axford was after, but he knew he was up to no good. Still, he found himself unable to keep silent.

" 'Stole,' Lou?" Alan heard himself saying. "Since when do patients belong to anybody? I haven't seen any yet that came with your Social Security number stenciled on them."

"They wouldn't be going to you now if you hadn't had your secretary call them all up and tell them where your new office was!"

I don't believe I'm getting sucked into this! Alan thought as he glared at the contentedly smiling Axford.